Adult Cardiac Surgery (NACSA) Context Page

The National Adult Cardiac Surgery Audit (NACSA) collects data on all major heart operations carried out in NHS hospitals and a selection of private hospitals throughout the UK. The audit is delivered by the National Institute of Cardiovascular Outcomes Research (NICOR) hosted by Barts Health NHS Trust.

View the Adult Cardiac Surgery (NACSA) benchmarks here.

To view the full audit data set visit NICOR website

Metrics:

Volume of operations

• Rationale: The number of operations indicates the volume of procedures that have been undertaken. In some situations larger volumes may be associated with better outcomes.
• Guideline/mapping: There is no national guideline related to volume of operations
• Graph/relative performance: Comparison to average.
• Quality improvement prompt question: Those sites with lower volumes should consider what local action they can take to ensure that operations being conducted at lower volumes are being conducted by team members with the necessary experience and training.

Risk adjusted in-hospital survival rate

• Rationale: The Survival gives a clear and concise view on the performance of each hospital. In-hospital survival data are collected on all patients who died before being discharged from hospital. This includes patients who die during their procedure or die after their operation before they have been discharged home. This may be as a result of complications of the surgery or maybe as a result of a separate disease or disorder.
• Guideline/mapping: There is no national guideline related to in-hospital survival rate.
• Graph/relative performance: A funnel-plot cross-section shows the position of the Trust relative to 99.8% (alarm) control limits. The grey zone means that the hospital’s performance is not statistically significantly different to the national average. Outside the grey zone means that the performance is significantly different to the national average..
• Quality improvement prompt question: Priority should be given to alarm level negative outliers. Performance outside of the expected range should prompt questions about action taken to identify any preventable causes of in hospital mortality and may include activities such as case note reviews.